Wi-Fi Internet Access Application
Billing Data
First Name:
Last Name:
Billing Address:
City:
State:
Zip Code:
Contact Phone:
Service Address:
City:
State:
Zip Code:
Identification
Full Name:
Driver's Lic #
Full Name:
Driver's Lic #
Full Name:
Driver's Lic #
List yourself, and any other associates who should have access to all aspects to this Account, including the ability to change Service Plans, add and delete E-mail addresses, change Passwords, and cancel service.
All RMU Wi-Fi Home Internet Access Accounts include the following:
Local Support - no waiting days for the big companies to respond
"Always On" Internet Access
Includes 5 Rochelle.net e-mail accounts
Connections may be shared by several computers
Totally mobile - take it anywhere in the City of Rochelle
Speeds up to 3 Mb!
Primary Log-In and E-mail Account
E-Mail names and passwords must be
6 to 8 letters and/or numbers long
(all small letters and no spaces)
. The name must start with a letter.
Primary Log-in/Email:
Password:
Additional E-mail Accounts
Second Log-in/Email:
Password:
Third Log-in/Email:
Password:
Fourth Log-in/Email:
Password:
Fifth Log-in/Email:
Password:
Additional Services
I would like more information regarding one or more of the following additional services. Please contact me at the number listed on this form.
NOTE:
Rochelle.Net
strongly
recommends the use of a firewall with any type of Internet connection.
Firewall
Router
Home Network
Unlimited Dial-Up Account $4.95 per month
Other
Subscriber Agreement
Click here to review our Subscriber Agreement.
I have read and agree to the RMU Subscriber Agreement referenced above.
Signature:
Date:
(MM/DD/YYYY)
Desired Start Date:
(MM/DD/YYYY)
© 2006 Rochelle Municipal Utilities. All rights reserved
333 Lincoln Highway., Rochelle, IL 61068
Phone: (815) 562-4155, Fax: (815)562-5861